Background/introduction:
When outbreaks of sexually transmitted infections (STIs) are identified, effective management in a timely manner is essential for bringing the outbreak under control. Challenges to achieving this may vary, needing different approaches.

Aim(s)/objectives:
To review the management of outbreaks contrasting by setting and sexual orientation in order to inform responsive guidance.

Methods:
We interviewed clinicians and public health professionals who had recently been involved in identifying and managing STI outbreaks in the United Kingdom.  Transcripts were analysed using thematic analysis.

Results:
Ten outbreaks were reviewed. The combination of public health teams’ wider outbreak expertise and clinic staff’s knowledge of the local population was essential when developing management strategies. Partner notification, mainly by health advisers, was very achievable in smaller heterosexual outbreaks but proved challenging in MSM focussed outbreaks where use of mobile apps or anonymous sex was common.
 
Publicity campaigns via social media platforms and third sector organisations were employed although quantifying their impact was difficult. Education of local physicians resulted in syphilis referrals to sexual health services via ophthalmology, gastroenterology, oral and maxillofacial surgery and general practice.  Enhanced surveillance enabled venue identification but was time consuming for clinic staff. In gonorrhoea outbreaks, the use of dual NAAT testing as part of the chlamydia screening programme enabled case finding.

Discussion/conclusion:
Traditional management strategies remain important but as the use of social media increases, novel strategies for managing outbreaks are needed. Education of other professionals is essential to maximise case finding.

Management of STI outbreaks. What can we learn from each other? A qualitative study in the UK.